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ENGAGEMENT LETTER. Adams Samartino & Company, PC PO Box 273 Bristol, CT

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STEP 1

ENGAGEMENT LETTER

Adams Samartino & Company, PC

PO Box 273

Bristol, CT 06011-0273

860-583-8675

Dear Client:

This letter is to confirm and specify the terms of our engagement with you and to clarify the nature and

extent of the services we will provide. In order to ensure an understanding of our mutual responsibilities, we

ask all clients for whom returns are prepared to confirm the following arrangements.

We will prepare your 2020 federal and resident income tax returns from information which you will furnish

to us. We will not audit or otherwise verify the data you submit, although it may be necessary to ask you for

clarification of some of the information. We will furnish you with questionnaires and worksheets to guide

you in gathering the necessary information. Your use of such forms will assist in keeping the fee to a

minimum.

This engagement does not include any other tax returns that you may be required to file such as Form 114,

Report of Foreign Bank and Financial Accounts (FBAR). If you have additional filing requirements, please

contact our office so that a separate engagement letter may be prepared.

It is your responsibility to provide all the information required for the preparation of complete and accurate returns.

You should retain all the documents, cancelled checks and other data that form the basis of income and deductions.

These may be necessary to prove the accuracy and completeness of the returns to a taxing authority. You have the

final responsibility for the income tax returns and, therefore, you should review them carefully before you sign

them.

Our work in connection with the preparation of your income tax return does not include any procedures designed to

discover defalcations and/or irregularities, should any exist. We will render such accounting and bookkeeping

assistance as determined to be necessary for preparation of the income tax returns.

The law provides various penalties that may be imposed when taxpayers understate their tax liability. If you would

like information on the amount or the circumstances of these penalties, please contact us.

Your returns may be selected for review by the taxing authorities. Any proposed adjustments by the examining

agent are subject to certain rights of appeal. In the event of such government tax examination, we will be available

upon request to represent you and will render additional invoices for the time and expenses incurred.

Our fee for these services will be based upon the amount of time required at standard billing rates plus

out-of-pocket expenses. All invoices are due and payable upon presentation. Invoices past due will incur a monthly

finance charge of 1.50 percent. In the unlikely event we should incur legal or other costs to collect our fee, you

agree to reimburse us for such costs.

You will be provided with one electronic copy or one paper copy of your tax returns. Requests for additional

copies may be subject to an additional fee.

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By signing this engagement letter, you have agreed to the fair allocation of risk between us. As such, you agree, to

the fullest extent permitted by law, to limit the liability of our firm to you for any and all claims, losses, costs and

damages of any nature whatsoever, so that the total aggregate liability of our accounting firm shall not exceed our

firm’s total fee for services rendered under this agreement. Both parties agree that there is a one-year limitation

period to bring a claim against us for errors or omissions. The one-year period will begin upon the date of the tax

professional’s signature on the tax returns covered by this engagement letter.

If the foregoing fairly sets forth your understanding, please sign in the space indicated and return it to our office.

However, if there are other tax returns you expect us to prepare, please inform us by noting so at the end of the

return copy of this letter.

We want to express our appreciation for this opportunity to work with you.

Very truly yours,

Adams Samartino & Company, PC

Accepted By: Taxpayer Signature - _______________________________

Print Name - _____________________________

Spouse Signature - _________________________________

Print Name - _____________________________

Date - ___________________________________

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STEP 2

CLIENT QUESTIONNAIRE

E-MAIL

– tax returns and mail supporting documents to me

OR

MAIL

– my tax returns and supporting documents to me

PLEASE PROVIDE DOCUMENTATION FOR ANY QUESTION ANSWERED YES

*ANY QUESTIONS NOT ADDRESSED WILL BE DEEMED ANSWERED NO*

Personal Information

Name - ________________________________________

Phone - __________________________________________ E-mail - ______________________________________________ Yes No

Did your marital status change during the year?

If yes, explain: ______________________________________________

Did your address change from last year?

If yes, when did you move?_________________________________________

New address?____________________________________________________ _______________________________________________________________ Did you get married to a same-sex spouse in a state that legally recognizes

same-sex marriage?

If yes, which state: _________________ Date of Marriage:_______________

Can you be claimed as a dependent by another taxpayer?

Did you change any bank accounts, or did routing transit numbers (RTN)

and/or bank account number change for existing bank accounts that have been used to direct deposit (or direct debit) funds from (or to) the IRS or other taxing authority

during that tax year?

If yes, please provide a voided check or the following information; Bank Name: _________________________________________________ Routing #________________________ Account #____________________ Is this a Checking______ or Savings ______ Account

Did you receive an Identity Protection PIN (IP PIN) from the IRS or have you

been a victim of identity theft? If yes, attach the IRS letter.

Dependent Information

Were there any changes in dependents from the prior year?

If yes, explain: ______________________________________________

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Yes No If you have added a dependent, please provide the following –

Name as it appears on their social security card _________________________ Date of Birth________________ Social Security Number_________________ Do you have any children under age 19 or a full-time student under age 24 with

unearned income in excess of $2,100?

Do you have dependents who must file a tax return?

If so, will they be claiming themselves? 

Did you provide over half the support for any other person(s) other than your

dependent children during the year?

Did you pay for child care while you worked or looked for work?

Did you pay any expenses related to the adoption of a child during the year?

If you are divorced or separated with child(ren), do you have a divorce decree

or other form of separation agreement which establishes custodial responsibilities?

Did any dependents receive an Identity Protection PIN (IP PIN) from the IRS or

have they been a victim of identity theft? If yes, attach the IRS letter

Purchases, Sales and Debt Information

Did you start a new business or purchase rental property during the year?

Did you acquire a new or additional interest in a partnership or S corporation?

Did you sell, exchange, or purchase any real estate during the year?

Did you acquire or dispose of any stock during the year?

Did you previously take out a home equity loan to improve your home?

Did you previously refinance a residence above the original purchase cost?

Did you lend money with the understanding of repayment in this year and it

became totally uncollectable?

Did you have any debts cancelled or forgiven this year, such as a home mortgage,

student loan(s) or credit cards?

Did you purchase a qualified plug-in electric drive vehicle or qualified fuel cell

vehicle this year?

Income Information

Did you have any foreign income or pay any foreign taxes during the year, directly

or indirectly, such as from investment accounts, partnerships or a foreign employer?

Did you receive any income from property sold prior to this year?

Did you receive any unemployment benefits during the year?

If yes, please provide Form 1099-G

Did you receive any disability income during the year?

Did you receive tip income not reported to your employer this year?

Did you receive any awards, prizes, hobby income, gambling or lottery winnings?

Do you expect a large fluctuation in income, deductions, or withholding next year?

Do you have any sales or other exchanges of virtual currencies, or used virtual

currencies to pay for goods or services, or you are holding virtual currencies as

an investment?

Retirement Information

If you are employed, are you an active participant in a pension or retirement plan?

Did you receive any Social Security benefits during the year?

Did you make any withdrawals from an IRA, Roth, Keogh, SIMPLE, SEP, 401(k), or

other qualified retirement plan?

If yes, were any withdrawals due to a Federally declared disaster?

Did you receive any lump-sum payments from a pension, profit sharing or

401(k) plan?

Did you make any contributions to an IRA, Roth, Keogh, SIMPLE, SEP, 401(k), or

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Yes No

Education Information

Did you, your spouse, or your dependents attend a post-secondary school

during the year, or plan to attend one in the coming year?

Did you have any educational expenses during the year on behalf of yourself,

your spouse, or a dependent? If yes, attach Form 1098-T

Do you have documentation to substantiate the educational expenses?

Did anyone in your family receive a scholarship of any kind during the year?

Did you make any withdrawals from an education savings or 529 Plan account?

Did you pay any student loan interest this year?

Did you cash any Series EE or I U.S. Savings bonds issued after 1989?

Did you make any contributions to an education savings or 529 Plan account?

Health Care Information

Did you have health insurance through the MARKETPLACE for the entire year?   If yes, please attach Form 1095-A

Did anyone in your family have Medicare or Medicaid coverage for the year?   Did you make contributions to a Health Savings Account (HSA)?   If yes, please attach Form 5498-SA

Did you make distributions from a Health Savings Account (HSA)?   If yes, please attach Form 1099-SA

Did you pay long-term care premiums for yourself or your family?  

Itemized Deduction Information

Did you incur a casualty or theft loss or any condemnation awards during the year?

Did you pay out-of-pocket medical expenses (Co-pays, prescription drugs, etc.)?

Did you make any cash or noncash charitable contributions (clothes, furniture, etc.)?

If yes, please provide a total amount and hold evidence such as a receipts from the

donee organizations, cancelled checks, or records of payment to substantiate contributions made for your records.

Did you donate a vehicle or boat during the year? If yes, attach Form 1098-C

or other written acknowledgement from the donee organization.

Did you make any major purchases during the year (cars, boats, etc.)?

Did you make any out-of-state purchases (by telephone, internet, mail, or in person)

for which the seller did not collect state sales or use tax?

Estimated Tax Payments

Please list dates and amounts paid for estimated payments to the IRS and states:

IRS CT Other States

Amount

Date Paid

Amount

Date Paid

Amount

Date Paid

Miscellaneous Information

Did you receive an economic impact payment (stimulus)?

If yes, please provide us with a copy of the letter you received stating the

amount received. If you did not receive a letter, please enter the amount received here $________________

Did you make gifts of more than $15,000 to any individual?

Did you utilize an area of your home for business purposes?

Did you engage in any bartering transactions?

Did you retire or change jobs this year?

Did you pay any individual as a household employee during the year?

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Yes No Did you make energy efficient improvements to your main home this year?

Did you receive a distribution from, or were you a grantor or transferor for a foreign

trust?

Did you have a financial interest in or signature authority over a financial account such as a bank account, securities account, or brokerage account, located in a

foreign country?

Do you have any foreign financial accounts, foreign financial assets, or hold

interest in a foreign entity?

Did you receive correspondence from the State or the Internal Revenue Service?

If yes, explain: ______________________________________________

Do you have previous years of tax returns that are either unfiled or filed with

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STEP 3

TAX DOCUMENTATION TO GATHER

- Forms W-2 for wages, salaries and tips.

- All Forms 1099 for interest, dividends, retirement, miscellaneous income.

- Form UC-1099G for unemployment income. (You must obtain this form online and print a copy. One will

not be sent to you.)

- Social Security, state or local refunds, gambling winnings, etc.

- Year-End tax information statements from brokerage accounts.

- Schedule K-1 from partnerships, S corporations, estates and trusts.

- Statements supporting deductions for mortgage interest, taxes, and charitable contributions

(including any Form 1098-C).

- Copies of closing statements regarding the sale or purchase of real property.

- Legal papers for adoption, divorce, or separation involving custody of your

dependent children.

- Any tax notices sent to you by the IRS or other taxing authority.

- A copy of your income tax return from last year, if not prepared by this office.

- A list of estimated tax payments made to the IRS and states – include amounts and dates.

- Support information for questions answered yes on client questionnaire.

- Form 1095-A Health Insurance Marketplace Statement

If you have any questions, please contact us at 860-583-8675 or via e-mail at

rjo@adamssamartinocpa.com

or

sem@adamssamartinocpa.com

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